Hypervigilance & Its Relevance To Combat PTSD

Lets first get the definition out of the way, being: Hypervigilance is an enhanced state of sensory sensitivity accompanied by an exaggerated intensity of behaviours whose purpose is to detect threats. It may feel like paranoia, but it's not the same.

Discard military for a second, and think PTSD in general. A symptom of PTSD is hypervigilance. This means, what society classifies as normal, being a person who lacks significant deviation from society and/or conforms to the ideals of society, typically has little to no requirement to be hypervigilant. Without fear there is no requirement to be looking for something. The most a civilian is partially hypervigilant is within daily acts of driving a motor vehicle and crossing the road. That is the typical extent of a civilians hypervigilance.

Now, a rape victim (male raped female). Due to the fear endured off being rendered powerless during the rape, the victim now creates a state of hypervigilance and awareness for any male who looks remotely threatening to themselves. They fear being raped again, so the brain has created an awareness and heightened state of alertness to specific males, even all males.

What have we learnt so far? We learnt that without any military training whatsoever, the brain can create a hypervigilant state to identify specific fears.

The military trains every recruit to a heightened level of hypervigilant status. This occurs from learning drill, to patrolling and tactics, weapons and so forth. You are trained to identify threats before they identify you. What is a threat? Something your brain distinguishes as a fear. Without any exposure to an actual trauma, every soldier has now been trained to a heightened symptom of PTSD through behavioural modification. The fear used for behavioural modification is imposed by a reward and punishment system. You do good, you don't get punished. You do bad, you get punished. Even when you do good, sometimes you still get punished. This mentally challenges you to strive for perfection, not just meeting a standard, but to perform to a high level and work as a team. Creating a team environment aids the process, as if you fail you're then punished by your peers. Fear in all forms is an exceptional motivator.

Depending on your role within any force, depends on how far your hypervigilant state will be trained. Infantry are trained to be extremely aware of everything around them. In a crowd the slightest movement is detected, eyes scanning for threats. Patrolling down a street, eyes constantly scanning doors, windows, cars, any movement or identification of an object that doesn't look right. IED's often fit right in with their surroundings, so even looking right is a threat.

Now the simplest of all issues combined; a person who has been trained to be hypervigilant prior to developing PTSD.

What have we learnt so far? The military trained you to be hypervigilant, yet when PTSD develops the brain also by itself creates a hypervigilant state. 1 + 1 = 2.

Why do military with PTSD have a much worse state of hypervigilance / alertness? Because not only have you been trained with a symptom of PTSD, but upon developing PTSD the symptom is now exacerbated in severity due to prior existence. One doesn't cancel the other out, instead 1 + 1 = 2 or PTSD Hypervigilance + Military Training Hypervigilance = Double The Symptom Severity.

Anthony, sticking with the maths, does [length of operational use/requirement of SOP hyper-vigilance] act as a straight multiplier of [PTSD hyper-vigilance]? (five years for me in NI alone).
And, if that (operational hyper-vigilance) were being used in an otherwise urban/'normal' environment, yep, Northern Ireland mid-late-eighties, would that lead to an increased inability to separate responses now?
Last question. If that period of using very fine-tuned (probably more akin to police) hyper-vigilance was punctuated by a series of pretty heavy first-person combat incidents, are those going to act like some kind of metal punch, stamping the habit/pattern even deeper into someones make-up? I think I know the answers but I would value your advice.

Hey Ned, Anthony is not well at the moment. The dreaded flu has put him on his arse, so it must be a bad one.

My opinion is that the length of service with regard to hyper-vigilance does not multiply. What he was getting at is, e.g. a person who works with stores for his career, is deployed to Iraq. He sees death and destruction, he stands watch at the gate. He is still taught to be hyper-vigilant, but it would not be as extreme as the standard infantry soldier who patrols the streets.

I find that now my hyper-vigilance comes and goes and the severity depends on my stress and anxiety levels. It can also be amplified by one of the many triggers.

I first saw combat in back in 1988 in South America. From 1988-2001 I did not "feel" or notice any PTSD symptoms. In 2001 I was activated again and I noticed that I was pulling back a little and getting uncomfortable in crowds, blah blah, blah. Since 2005 it has been a freight train blasting through my life.

So my questions are:
Was it always there and just waiting to come out?
Or
Did something happen that was 'worse' the second, third, and fourth times around? In actuality South America was far more violent, up close and personal.

Mate, its probably a stupid question, but have you watched Band of Brothers??
Some of them suffered straight away, yet others suffered nearly 30 years down the track and sometimes further.

Myself, I was in New Guinea in 2000, and East Timor in 2002. I had some symptoms of PTSD after Timor, and that was mainly the anger issues. It was not until I returned from Iraq in 2006 that the full extent of the symptoms took hold.
And it was not until 2008 or 2009 that my therapist dug some of my traumas up from both New Guinea and East Timor.

Right now, I am a little jumpy at times, but I know for a fact that when the choppers start doing night time ops, or the F18's are in town, my levels build. Call it self awareness, but I can tell when an episode is happening and that's when my hypervigelence is at its worst.

So maybe I have no idea at all. Anthony is doing lots of study on this and wrote the original document, so I will ask him.

Its like how can there be three people standing side by side in a particular fire fight where their best mates are blown to hell etc, etc.

One turns into an instant gibbering wreck and is evacuated into a psych ward.
One is never affected, and
One 20 years later starts having nightmares and suffering from the symptoms of PTSD.

You see, continuing to serve can help to mask the symptoms when you think about it. You are in a military environment where a lot of yelling and anger freely occurs. Security is always at the it peak and people are disciplined.
It could be just a level building up in your body which like a cork eventually pops.

Anthony, sticking with the maths, does [length of operational use/requirement of SOP hyper-vigilance] act as a straight multiplier of [PTSD hyper-vigilance]?... ...were being used in an otherwise urban/'normal' environment, yep, Northern Ireland mid-late-eighties, would that lead to an increased inability to separate responses now?

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In a nutshell.... absolutely.

If you served 5 years in a combatant urban environment of threat, then absolutely that would make it more difficult for you to separate your fear responses now back in a non-threatening urban environment.

If you served 5 years in a combatant urban environment of threat, then absolutely that would make it more difficult for you to separate your fear responses now back in a non-threatening urban environment.

Think Jimmy hit the nail on the head there,hubbys was masked for 14 years after getting out due to a shedload of other family traumas that required him to be strong for all of us,it was only realy at the start of last year when for once in our lives we were all at peace with the world that this struck with a vengence,the docs keep asking what happened to kick it all off last year and I tell them it appears to me to be the reverse,Joes head seemed to just go .."right nothing going on that requires me to keep a lid on it so now is the time to let it all out"

Don't get me wrong above though... in that all fears can still be removed / eliminated, though due to the specifics of duration in urban warfare... I would imagine it may take more time than most, but still very achievable.

Cheers Anthony. That makes sense. I know there's some things that are too ingrained to excise, and most of them are, anyway, harmless and just a bit of OCD to the average civvy (never park nose in, always sit back to wall so you can see the door, rooftop & side street scans, blah blah blah) but it would be nice to reduce the threat state a bit! (Except when visiting Essex, of course).

Hey Ned, I don't think any of us will change in that way. I think we will always scan the surrounding area, and always sit where we can see the exits. That is a lot to do with military training on top of hypervigelence.
Yeah we can back off a bit, but I think it will always be there. And in this ever changing society, its probably a good idea.
Its also why us vets are starting to move to secure gated communities, or out in the country.

Hey Ned, I don't think any of us will change in that way. I think we will always scan the surrounding area, and always sit where we can see the exits. That is a lot to do with military training on top of hypervigelence.
Yeah we can back off a bit, but I think it will always be there. And in this ever changing society, its probably a good idea.
Its also why us vets are starting to move to secure gated communities, or out in the country.

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Quite, and right. Never felt more secure than on top of an isolated hill. And you are right, the more noise that can be removed, the less to process. I put a reply to Kafdog pointing out that there's very little point in trying to lose what you've learnt, why would you?

She nags me about my 6th sense/ESP but every now and then there's a 'thank f##k' incident, even in dainty Cheltenham. And thats only the stuff she notices....

And yes, urban is getting crap. They all seem to be introverted selfish children. I am on the edge of town, all my mates are rural and it's two different communities. None of my farmer mates have served but by heck I've got more in common with them than the peple next door.

You can change the constant scanning, requiring to sit near exits, or see exits, etc... you can change all these behaviours. Because the military put them within us, and then combat reinforced there validity that saved us, in essence, as we came home, the difference is now through the very same repetitive training we undertook in the first place to get drilled with these aspects, to undo them. I will say though, because they have been reinforced by combat, they are harder to change....

Will you ever completely remove them 100%? No... and the reason is because it will depend on your mood. If you get yourself to the point where you're going to the shops, feel good going in, good coming out, then you can absolutely change your behaviour with scanning and being alert. When habits will come back though is when you enter a shopping center or such, and your anxiety is already heightened... then your brain tells you that your combat training is required, even though its not... but anxiety dictates differently.

Change the anxiety and stress levels period, you also change the other negative behaviours of scanning and being hypervigilant.

How do you do that? Through exposure and practice, practice, practice, repetition, repetition, repetition in actual locations. Literally, focus on being completely blase within a shopping center, walk through, bump in people in crowds, etc... apologise, reinforce the difference of civilian environment to combat. Bumping into someone here is an accident, not a threat... even though you are intentionally doing it as part of self retraining... they don't know that. But it works...

Work at the core of the issues... lower overall anxiety, back it up with exposure, and lots of it. You suddenly find yourself within a crowded shopping center for hours, without coming out all worn out from constant scanning and alertness... you just relax and browse / shop.

Use logic... when someone is frustrating you, logic dictates, you may just as well be frustrating them, either walking too fast, or not fast enough. Crowded shops.... others are just as frustrated as you are, use that logic to keep calm, keep anxiety down, and look around whilst in lines, or say, excuse me, to get past someone... lots and lots of practice makes perfect mentally.

This is really a good thread guys. Explains allot about my hyper vigilance I'll say that. But I'm not sure if I'll ever get over my issues with ships.

I used to live on an Island of sorts in Oslo Fjord, so we had to take the ferry every day into town and back. I never sat inside. -20c and I'm on deck keeping watch. No way I could be in with the crowd trapped. The old sailors on board understood. Always smiled and said hello. Never ever tried to make me go in. Others they did, but not me. Then we got new ferries and they got rid of the old crew. They don't know it, but life boats came near to being launched a few times.

Practice practice. It's Friday. I like the idea Anthony. Think I'll try to engage in some practice today. Thanks and good weekend all.

Literally, focus on being completely blase within a shopping center, walk through, bump in people in crowds, etc... apologise, reinforce the difference of civilian environment to combat. Bumping into someone here is an accident, not a threat... even though you are intentionally doing it as part of self retraining... they don't know that. But it works...

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Well, on Saturday, I did that. And it was amazingly easy. OK, I cheated a bit. I thought before hand - 'someone has given me a good plan and I know the ground and I'm going to go in and, barring a freak-out, stick to the plan'.
It certainly does work, came out of the store (after two shopping sessions), totally calm. Went home, unpacked, spent a really nice three hours with my girl who was amazed at the difference in me.
Result.
An Apollo moment, one small step for a weekend, one giant leap over the years.